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Free CCRN Practice Questions

10 free, exam-style Certification in Acute/Critical Care Nursing (CCRN) practice questions with answers and explanations. No signup required. Work through them below, then take the full free CCRN practice test to study every exam domain.

Question 1

A patient's PA catheter readings show: RAP 4 mmHg, PA 38/22 mmHg, PCWP 8 mmHg, CO 3.2 L/min, SVR 1,800 dynes·s/cm⁻⁵. This hemodynamic profile is MOST consistent with:

  1. Cardiogenic shock
  2. Right ventricular failure
  3. Septic shock (warm phase)
  4. Hypovolemic shock
Show answer & explanation

Correct answer: D - Hypovolemic shock

Question 2

A patient in cardiogenic shock has the following hemodynamic values: CI 1.6 L/min/m², PCWP 26 mmHg, SVR 2,400 dynes·s/cm⁻⁵. Which medication is MOST appropriate to improve cardiac output while reducing afterload?

  1. Vasopressin
  2. Phenylephrine
  3. Dobutamine
  4. Norepinephrine
Show answer & explanation

Correct answer: C - Dobutamine

Question 3

After receiving 30 mL/kg of crystalloid, a patient with septic shock remains hypotensive with a MAP of 56 mmHg. The NEXT intervention is:

  1. Administer a dobutamine infusion
  2. Start a norepinephrine infusion
  3. Administer an additional 30 mL/kg bolus
  4. Insert a pulmonary artery catheter
Show answer & explanation

Correct answer: B - Start a norepinephrine infusion

Question 4

During DKA treatment, the patient's blood glucose drops to 220 mg/dL but the anion gap remains elevated at 18. The nurse should anticipate:

  1. Adding dextrose to IV fluids while continuing insulin infusion
  2. Stopping the insulin infusion since glucose is improving
  3. Switching to subcutaneous insulin administration
  4. Administering sodium bicarbonate to correct acidosis
Show answer & explanation

Correct answer: A - Adding dextrose to IV fluids while continuing insulin infusion

Question 5

A patient with AKI develops a potassium of 6.8 mEq/L with peaked T waves and widened QRS on ECG. The FIRST medication to administer is:

  1. Insulin with D50
  2. Kayexalate (sodium polystyrene sulfonate)
  3. Sodium bicarbonate
  4. Calcium gluconate IV
Show answer & explanation

Correct answer: D - Calcium gluconate IV

Question 6

A patient with ARDS has the following ventilator settings: AC/VC, VT 350 mL (6 mL/kg IBW), RR 24, PEEP 14, FiO₂ 80%. ABG shows pH 7.18, PaCO₂ 65, PaO₂ 52. The MOST appropriate NEXT intervention is:

  1. Increase the tidal volume to 600 mL
  2. Switch to SIMV mode with no pressure support
  3. Increase the respiratory rate and consider prone positioning
  4. Decrease the PEEP to 5 to improve hemodynamics
Show answer & explanation

Correct answer: C - Increase the respiratory rate and consider prone positioning

Question 7

A patient develops acute respiratory distress, bilateral pulmonary infiltrates, and hypoxemia 3 hours after a blood transfusion. Blood pressure is 84/52 mmHg and BNP is normal. This is MOST consistent with:

  1. Pulmonary embolism
  2. TRALI (transfusion-related acute lung injury)
  3. TACO (transfusion-associated circulatory overload)
  4. Acute hemolytic reaction
Show answer & explanation

Correct answer: B - TRALI (transfusion-related acute lung injury)

Question 8

A patient with a T4 spinal cord injury develops a sudden severe headache, blood pressure of 230/120 mmHg, bradycardia, flushing and diaphoresis above the injury level, and goosebumps below. The FIRST nursing action is:

  1. Administer antihypertensives immediately
  2. Place patient flat and administer IV fluids
  3. Give atropine for bradycardia
  4. Sit patient upright and remove triggering stimulus
Show answer & explanation

Correct answer: D - Sit patient upright and remove triggering stimulus

Question 9

A patient's ICP is 32 mmHg. The EVD is open and draining, HOB is at 30 degrees, and the head is midline. Mannitol was given 30 minutes ago without improvement. The NEXT intervention the nurse should anticipate is:

  1. Discontinue the EVD
  2. Increase IV fluids
  3. Administer aspirin
  4. Administer hypertonic saline
Show answer & explanation

Correct answer: D - Administer hypertonic saline

Question 10

A patient's advance directive states no intubation. The family insists the patient be intubated. The nurse's MOST appropriate action is:

  1. Honor the patient's advance directive, which represents the patient's autonomous wishes
  2. Convene an ethics committee to mediate between the family and directive
  3. Document the conflict and seek legal counsel before proceeding with care
  4. Obtain a second medical opinion to validate the advance directive's applicability
Show answer & explanation

Correct answer: A - Honor the patient's advance directive, which represents the patient's autonomous wishes

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